<b>A Laparoscopic Access Technique for Endovascular Procedures:</b>Surgeon Training in an Animal Model

Fearn, Shirley J.; Burke, Kathleen G; Hartley, David E.; Semmens, James B.; Lawrence-Brown, Michael

doi:10.1583/05-1787.1

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…Following randomization, participants are put into training pairs, which is a common practice within surgical training [ 20 , 21 ]. This allows the trainees to give each other real-time competency assessment and feedback, which is motivational [ 22 , 23 ], in addition to saving time for the trainers, and space in the training center.…”

Section: Methodsmentioning

confidence: 99%

Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying – study protocol for a randomized controlled trial “The shoebox study”

Hendrie

Nickel

Brückner

et al. 2016

Trials

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BackgroundLaparoscopy training has become an integral part of surgical education. Suturing and knot tying is a basic, yet inherent part of many laparoscopic operations, and should be mastered prior to operating on patients. One common and standardized suturing technique is the C-loop technique. In the standard training setting, on a box trainer, the trainee learns the psychomotor movements of the task and the laparoscopic visuospatial orientation simultaneously. Learning the psychomotor and visuospatial skills separately and sequentially may offer a more time-efficient alternative to the current standard of training.MethodsThis is a monocentric, two-arm randomized controlled trial. The participants are medical students in their clinical years (third to sixth year) at Heidelberg University who have not previously partaken in a laparoscopic training course lasting more than 2 hours. A total of 54 students are randomized into one of two arms in a 1:1 ratio to sequential learning (group 1) or control (group 2). Both groups receive a standardized introduction to the training center, laparoscopic instruments, and C-loop technique. Group 1 learn the C-loop using a transparent shoebox, thus only learning the psychomotor skills. Once they reach proficiency, they then perform the same knot tying procedure on a box trainer with standard laparoscopic view, where they combine their psychomotor skills with the visuospatial orientation inherent to laparoscopy. Group 2 learn the C-loop using solely a box trainer with standard laparoscopic view until they reach proficiency. Trainees work in pairs and time is recorded for each attempt. The primary outcome is mean total training time for each group. Secondary endpoints include procedural and knot quality subscore differences. Tertiary endpoints include studying the influence of gender and video game experience on performance.DiscussionThis study addresses whether the learning of the psychomotor and visuospatial aspects of laparoscopic suturing and knot tying is optimal sequentially or simultaneously, by assessing total training time, procedural, and knot quality differences between the two groups. It will improve the efficiency of future laparoscopic suturing courses and may serve as an indicator for laparoscopic training in a broader context, i.e., not only for suturing and knot tying.Trial registrationThis trial was registered on 12 August 2015 with the trial registration number DRKS00008668.

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Section: Methodsmentioning

confidence: 99%

Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying – study protocol for a randomized controlled trial “The shoebox study”

Hendrie

Nickel

Brückner

et al. 2016

Trials

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“…20 In a porcine model, they used a curved hollow needle, a partially stented Dacron conduit, an airtight laparoscopic port, and a sealing sheath and valve specifically developed for percutaneous access through the abdominal wall. The conduit was inserted over the guide wire after needle removal and deployed under fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

A total laparoscopic technique for endovascular thoracic stent graft deployment

Yoshida

Kolvenbach

et al. 2010

Journal of Vascular Surgery

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Totally laparoscopic assisted graft implantation in aorta or iliac arteries provides a safe and effective access for the endovascular delivery system. However, further evaluation and long follow-up are necessary to ensure the potential advantages of this technique. It is a less invasive option to overcome access-related problems with thoracic endograft deployment, giving the patient the advantage of a totally minimal invasive procedure.

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“…Experimental procedures in pigs frequently require access to blood vessels, such as hepatic vein (Farias et al 1986), portal vein (Kaiser et al 2005), external jugular vein Lombardo et al 2010), internal carotid artery (Nsadi et al 2011), common iliac artery (Fearn et al 2006), femoral vein (Pinkernelle et al 2009), cranial vena cava (Damm et al 2000), and pulmonary artery (Holmes and Weiskopf 1990). Multiple abdominal intravascular catheterization in pigs is also a common surgical procedure and an important research tool in animal nutrition (Bajjalieh et al 1981;Olesen et al 1989;Stoll et al 1998;Yen et al 2004;Hooda et al 2009).…”

Section: Introductionmentioning

confidence: 99%

“…However, there have been only a few previous reports of laparoscopic endovascular catheterization performed in pigs (Fearn et al 2006), and a technique for laparoscopic multiple endovascular catheterization performed in pigs has not been described. Furthermore, for successful quantitative investigations of portal-drained viscera (PDV) metabolism, it is essential that catheter tips remain in their predetermined positions that in turn make proper fixation of catheters a critical factor.…”

Section: Introductionmentioning

confidence: 99%

Minimally-invasive catheterization of portal and mesenteric veins and abdominal aorta for quantitative determination of portal-drained viscera metabolism in pigs

Zhang

Wang²,

Tong³

et al. 2016

Can. J. Anim. Sci.

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A laparoscopic catheterization of portal and ileal veins as well as abdominal aorta was performed in eight pigs under general anesthesia for quantitative determination of portal-drained viscera metabolism. Three polyurethane catheters were introduced into the target vessels through an abdominal wall cannula using the guide catheter and wire. Surgery duration, length of incisions, and postoperative outcomes were recorded. On days 7 and 30, portal vein blood flow rates were measured by paraaminohippuric acid method. On day 35, a second laparoscopy was performed to monitor the setup of intraabdominal catheters. The laparoscopic procedures were completed with a mean operative time of 82 ± 9 min, and mean total incision size was 4.5 ± 0.5 cm. No major intraoperative or postoperative complications were encountered. The second laparoscopy showed that position and fixation of catheters remain stable 35 d after the surgical preparation. Portal vein blood flow remained similar (P > 0.05) from 7 to 30 d after the laparoscopic surgical procedure. Retention of catheters in six pigs was more than 60 d, and the other two were 42 and 56 d. We conclude that this novel technique is an attractive alternative to traditional surgical catheterization procedures.Key words: laparoscopy, multiple endovascular catheterization, technique, pig.Résumé : Un cathétérisme laparoscopique des veines portes et iléales ainsi que de l'aorte abdominale a été effectuée chez huit porcs sous anesthésie générale pour la détermination quantitative du métabolisme des viscères drainés par la veine porte. Trois cathéters en polyuréthane ont été introduits dans les vaisseaux sanguins cibles par une canule dans la paroi abdominale en utilisant un cathéter guide et un fil. La durée de chirurgie, la longueur des incisions ainsi que les résultats postopératoires ont été enregistrés. Au jours 7 et 30, les débits de sang dans la veine porte ont été mesurés par la méthode de l'acide para-aminohippurique (PAH). Au jour 35, une deuxième laparoscopie a été effectuée pour surveiller l'installation des cathéters intra-abdominaux. Les procédures laparoscopiques ont été terminées avec un temps moyen d'opération de 82 ± 9 min et la longueur moyenne totale de l'incision était de 4,5 ± 0,5 cm. Aucune complication majeure pendant ou après opération n'ont été rencontrées. La deuxième laparoscopie a montré que la position et la fixation des cathéters demeuraient stables 35 jours après la préparation chirurgicale. Les débits de sang dans la veine porte demeurent similaires (P > 0,05) des jours 7 à 30 après la chirurgie laparoscopique. La rétention des cathéters dans six des porcs a été de plus de 60 jours tandis qu'elle était de 42 et 56 chez les deux autres. Nous concluons donc que cette nouvelle technique est une alternative attrayante aux procédures traditionnelles chirurgicales de cathétérisme. [Traduit par la Rédaction] Mots-clés : laparoscopie, cathétérisme endo-vasculaire multiple, technique, porc.

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A Laparoscopic Access Technique for Endovascular Procedures:Surgeon Training in an Animal Model

Cited by 13 publications

References 20 publications

Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying – study protocol for a randomized controlled trial “The shoebox study”

Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying – study protocol for a randomized controlled trial “The shoebox study”

A total laparoscopic technique for endovascular thoracic stent graft deployment

Minimally-invasive catheterization of portal and mesenteric veins and abdominal aorta for quantitative determination of portal-drained viscera metabolism in pigs

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